The distribution of HD according to variables such as age, sex, race, and ethnicity has been documented. However, evidence about the association of socioeconomic status and motor, cognitive, behavioral, functional, and independence outcomes according to the social vulnerability index (SVI) is missing.

This is a cross-sectional study. HD pathogenic-variant carriers from the UTHealth Houston Huntington Disease Society of America Center of Excellence participating in Enroll-HD were included in the study. We included clinical data derived from the Unified Huntington Disease Rating Scale (UHDRS). The SVI was calculated based on the participant’s current address. Associations between dichotomous variables were assessed with the Chi-Square or Fisher's exact test.

We included 131 participants with a confirmed diagnosis of HD. Mean age was 45.6 years, with 58.7% identified as females. Patients with less educational years had an SVI > 50^th percentile (p = 0.0004). Interestingly, patients with an SVI > 50^th percentile had lower correct responses in the Categorical Verbal Fluency test (p = 0.0405). Patients with an SVI > 75^th percentile had lower scores in the TFC section of the UHDRS (p = 0.029). There was a significant correlation between lower years of education (ρ = -0.398, p < 0.001) and less correct responses in the verbal fluency task (ρ = -0.189, p = 0.036) and higher SVI. There was a significant difference regarding SVI between White individuals and African-Americans, Hispanic/Latino, American-Indian, and Asian participants (p = 0.047).

Socioeconomic factors play an important role in the morbidity of patients with HD. The SVI is an important way of addressing the needs of the patients based on their location, which can lead to the creation of public policies to treat modifiable risk factors and improve their quality of life.